Đặc điểm lâm sàng và cận lâm sàng trên bệnh nhân nhồi máu não có hẹp động mạch não giữa=Clinical and paraclinical characteristics in patients with cerebral infarction in the middle cerebral artery stenosis

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Tác giả: Tấn Phúc Huỳnh, Huy Thắng Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.54-61

Bộ sưu tập: Metadata

ID: 242224

Thêm vào giỏ

Nghiên cứu nhằm phân tích các đặc điểm cơ bản, lâm sàng, cận lâm sàng và những yếu tố ảnh hưởng tới mức độ hẹp động mạch não giữa, đánh giá kết quả lâm sàng sau 90 ngày ở những bệnh nhân này. Phương pháp: Nghiên cứu mô tả, quan sát dọc tại Bệnh viện Đa khoa Đồng Nai từ tháng 8 năm 2022 đến tháng 2 năm 2023 trên 93 bệnh nhân nhập viện do đột quỵ nhồi máu não cấp tính có hẹp động mạch não giữa. Kết quả: Độ tuổi trung bình: 62 tuổi, rối loạn ngôn ngữ (53%), liệt dây thần kinh sọ số VII (36.6%), rối loạn ý thức và yếu/ liệt nửa người (12.9%). Điểm NIHSS trung bình khi nhập viện (5.03±3.98), khuyết tật nhẹ hoặc không khuyết tật theo thang điểm mRS (97.8%), tăng huyết áp (72%). Có (79.5%) hẹp M1 (48.4% hẹp nhẹ đến trung bình, 51.6% hẹp nặng hoặc tắc mạch). Nhồi máu lãnh thổ (55.9%), nhồi máu nhánh xuyên (24.7%) và nhồi máu hỗn hợp (17.2%). Có mối liên quan giữa mức độ hẹp động mạch não giữa với tuổi, hút thuốc, tiền sử tăng huyết áp và tập thể dục. Tỷ lệ tái phát (19.4%), tử vong (8.6%). Các kết quả sau 90 ngày có liên quan đến tiền sử tăng huyết áp, rối loạn ngôn ngữ, điểm NIHSS khi nhập viện và ra viện, điểm mRS, và thời gian nằm viện. Tỷ lệ tử vong cao ở những bệnh nhân có rối loạn ý thức và điểm NIHSS cao. Kết luận: Có mối liên quan giữa mức độ hẹp động mạch não giữa với tuổi, hút thuốc lá, tiền sử tăng huyết áp, và hoạt động thể lực. Có mối liên quan chặt sau 90 ngày với các yếu tố rối loạn ngôn ngữ, điểm NIHSS khi nhập viện và ra viện, thời gian nằm viện. Tỷ lệ tử vong cao hơn gặp ở những bệnh nhân có rối loạn ý thức và điểm NIHSS cao.The study aimed to analyze the basic, clinical, paraclinical characteristics and factors affecting the degree of middle cerebral artery stenosis, and evaluate the clinical results after 90 days in children. these patients. Subject and methods: descriptive, longitudinal study at Dong Nai General Hospital from August 2022 to February 2023 on 93 patients hospitalized for acute ischemic stroke with middle cerebral artery stenosis. Results: Average age: 62 years old. Clinical symptoms: speech disorders (53%), cranial nerve VII paralysis (36.6%), consciousness disorders and weakness/ hemiplegia (12.9%). Average NIHSS score upon admission (5.03±3.98), mild disability or no disability according to the mRS scale (97.8%) , hypertension (72%). There were (79.5%) M1 stenosis (48.4% mild to moderate stenosis, 51.6% severe stenosis or occlusion). Territorial infarction (55.9%), perforating branch infarction (24.7%), and mixed infarction (17.2%). There is an association between the degree of middle cerebral artery stenosis and age, smoking, history of hypertension and exercise. Recurrence rate (19.4%) and death (8.6%). Three-month outcomes were related to history of hypertension, speech disorders, NIHSS scores at admission and discharge, mRS scores, and length of hospital stay. Higher mortality was observed in patients with impaired consciousness and high NIHSS scores. Conclude: There is a relationship between the degree of middle cerebral artery stenosis and age, smoking, history of hypertension, and physical activity. After three months, the results showed a strong association with the above factors along with language disorders, NIHSS scores upon admission and discharge, and length of hospital stay. Higher mortality rates were seen in patients with impaired consciousness and high NIHSS scores.

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